title: The effectiveness of a proactive coping intervention targeting self-management in diabetes patients.
abstract: OBJECTIVE
  The study's aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention's effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.
  
  
  METHODS
  A total of 141 type 2 diabetes patients were included in the intervention. The intervention employed a 5-step approach to target proactive coping skills. Psychological (e.g. proactive coping and self-efficacy) and behavioural variables (e.g. self-care, diet and physical activity) were assessed at baseline (T1), after the initial phase of the intervention (T2), after the booster phase (T3) and at follow-up (T4), comprising a total period of 15 months. Medical variables were assessed at T1 and T4.
  
  
  RESULTS
  Employing piecewise Latent Growth Curve Modelling, results showed that participants improved on all psychological and behavioural variables during the initial phase and maintained these improvements over 12 months. The booster phase yielded no further improvements. Mixed findings were obtained on medical outcomes.
  
  
  CONCLUSIONS
  The original intervention is effective, but the added value of the booster sessions is uncertain.
authors.affiliation: a Department of Clinical and Health Psychology , Utrecht University , Utrecht , The Netherlands.
authors.forename: Floor M
authors.initials: FM
authors.lastname: Kroese
authors.forename: Marieke A
authors.initials: MA
authors.lastname: Adriaanse
authors.forename: Charlotte D W
authors.initials: CD
authors.lastname: Vinkers
authors.forename: Rens
authors.initials: R
authors.lastname: van de Schoot
authors.forename: Denise T D
authors.initials: DT
authors.lastname: de Ridder
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D004032:Diet / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015397:Program Evaluation; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy